Dream Lab Counseling | |
4613 Parkway Dr Suite 5 Texarkana AR 71854-1142 | |
(918) 510-6066 | |
Not Available |
Full Name | Dream Lab Counseling |
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Speciality | Counselor |
Location | 4613 Parkway Dr, Texarkana, Arkansas |
Authorized Official Name and Position | Kizer Contrel Neal (OWNER/THERAPIST) |
Authorized Official Contact | 8705877021 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dream Lab Counseling 4613 Parkway Dr Suite 5 Texarkana AR 71854-1142 Ph: (918) 510-6066 | Dream Lab Counseling 4613 Parkway Dr Suite 5 Texarkana AR 71854-1142 Ph: (918) 510-6066 |
NPI Number | 1073051504 |
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Provider Enumeration Date | 02/03/2017 |
Last Update Date | 07/21/2022 |
Certification Date | 07/15/2022 |
Medicare PECOS PAC ID | 5890054779 |
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Medicare Enrollment ID | O20180123000879 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073051504 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Kizer Contrel Neal |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1366772386 PECOS PAC ID: 0840558326 Enrollment ID: I20171212000713 |
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